Nicardipine

General

Adult Dosing

Hypertension

  • PO: 20-40mg q8hr, or 30-60mg (extended release) q12hr
  • IV: 5mg/hr by slow infusion (50ml/hr), titrate to maximum of 30mg/hr, then maintenance of 2.0 - 15.5mg/hr
  • IV bolus dose of 2mg, then continuous infusion achieves same control of hypertension as starting infusion without bolus[1]

Chronic Stable Angina

  • 20-40mg PO q8hr
  • Allow 3 days between dose increase

Pediatric Dosing

Hypertension

  • 0.5-3 mcg/kg/min IV
  • Not approved by FDA; limited date available

Special Populations

  • Pregnancy Rating: Category C
  • Lactation: Unknown wether drug is excreted in breast milk; avoid use
  • Renal Dosing
    • Adult
    • Pediatric
  • Hepatic Dosing
    • Adult
    • Pediatric

Contraindications

  • Allergy to class/drug

Adverse Reactions

Serious

Common

Pharmacology

  • Half-life: 2-4 hr
  • Metabolism: Metabolized in liver b CYP3A4 (first pass)
  • Excretion: urine (60%), feces (35%)
  • Mechanism of Action:
    • inhibits trasmembrane influx of extracellular calcium ions across membranes of myocardial cells and vascular smooth muscle cells without changing serum calcium concentrations; this inhibit cardiac and vascular smooth muscle contractions, thereby dilating maincoronary and systemic arteries.

See Also

References

  1. Tao P, Zheng DY, Yu XJ. Effects of intravenous nicardipine in Chinese patients with hypertensive emergencies. Curr Ther Res Clin Exp 1998 Mar; 59: 188-95.